Iris Gancinia Carreon, RN
Registered Nurse, Medical-Surgical in Tucker, GA. Individual provider (NPI-1).
NPI number1417618562
StatusActive
Last updated in NPPESDec 31, 2021
Details
- NPI
- 1417618562
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Iris Gancinia Carreon
- Credential
- RN
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Dec 31, 2021
- Certification date
- Dec 31, 2021
- Last updated
- Dec 31, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163WM0705X | Registered Nurse, Medical-Surgical | RN237347 | GA | Yes |
| 163WP0809X | Registered Nurse, Psych/Mental Health, Adult | RN237347 | GA | |
| 163WX0200X | Registered Nurse, Oncology | RN237347 | GA |
Other names
- Iris Buenagua Gancinia (Former Name)
Practice location
4486 Lashley DrTucker, GA 30084-2750
Phone 770-776-8859
Mailing address
4486 Lashley DrTucker, GA 30084-2750
Phone 770-776-8859
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